Relationship Between Serum Osteocalcin Levels and Glycosylated Hemoglobin in Type II Diabetes Patients

Osteocalcin Levels and Glycosylated Hemoglobin in Diabetes Patients


  • Maria Mufti Department of Physiology, Federal Medical and Dental College, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
  • Nida Khaliq Fazaia Medical College, Air University, Islamabad, Pakistan
  • Mehtab Munir Department of Physiology, Federal Medical and Dental College, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
  • Almas Khattak Department of Medicine, Northwest School of Medicine, Peshawar, Pakistan
  • Arsalan Mufti Department of Emergency Medicine, Ziauddin University Hospital, Karachi, Pakistan
  • Fakeha Ansari Foundation University College of Dentistry, Rawalpindi, Pakistan
  • Bilqis Hassan Department of Medical Education, Northwest School of Medicine, Peshawar, Pakistan
  • Farrukh Ansar Quaid e Azam International Hospital, Islamabad, Pakistan



Osteocalcin levels, HbA1c levels, Type 2 Diabetes Mellitus


Diabetic osteopathy is a complication of diabetes that elevates the risk of bone fractures and influences bone remodeling. Osteocalcin is a bone protein produced by osteoblasts that plays a role in the regulation of glucose and energy metabolism. Objectives: To explore the relationship between the level of glycosylated hemoglobin (HbA1c) and osteocalcin in diabetic patients. Methods: This cross-sectional analytical study was carried out at Hayatabad Medical Complex, Peshawar from January 2017 to February 2018. A total of 100 patients suffering from Type 2 Diabetes Mellitus (T2DM) were recruited. HbA1c and osteocalcin levels were measured by the enzymatic method and electrochemiluminescence immunoassay, respectively. SPSS was utilized for data entry and analysis; Pearson’s correlation was performed to assess the relationship between variables while statistical significance was accepted at p < 0.05. Results: The mean (SD) age of participants was 50 (9.2), while 58% of the study population was female. The mean (SD) HbA1c and osteocalcin levels were 11.3 (8.8) and 13.1 (6.8), respectively. The results of the correlation analysis yielded a negative relationship between HbA1c and osteocalcin levels (r =-0.099), but the results were statistically non-significant (p-value =0.328). Conclusion: Our study suggested that osteocalcin level has a negative correlation with HbA1c level in Type 2 Diabetes Mellitus patients


Hwang YC, Kang M, Cho IJ, Jeong IK, Ahn KJ, Chung HY, et al. Association between the circulating total osteocalcin level and the development of cardiovascular disease in middle-aged men: a mean 8.7-year longitudinal follow-up study. Journal of Atherosclerosis and Thrombosis. 2015 Feb; 22(2): 136-43. doi: 10.5551/jat.25718

Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X, et al. Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Scientific Reports. 2020 Sep; 10(1): 1-11. doi: 10.1038/s41598-020-71908-9

World Health Organization. Global report on diabetes. 2016. [Last Cited on: 29thNovember2022] Available at:

Zoch ML, Clemens TL, Riddle RC. New insights into the biology of osteocalcin. Bone. 2016 Jan; 82: 42-9. doi: 10.1016/j.bone.2015.05.046

Kunutsor SK, Apekey TA, Laukkanen JA. Association of serum total osteocalcin with type 2 diabetes and intermediate metabolic phenotypes: systematic review and meta-analysis of observational evidence. European journal of epidemiology. 2015 Aug; 30(8): 599-614. doi: 10.1007/s10654-015-0058-x

Lee NK, Sowa H, Hinoi E, Ferron M, Ahn JD, Confavreux C, et al. Endocrine regulation of energy metabolism by the skeleton. Cell. 2007 Aug; 130(3): 456-69. doi: 10.1016/j.cell.2007.05.047

Lerchbaum E, Schwetz V, Nauck M, Völzke H, Wallaschofski H, Hannemann A. Lower bone turnover markers in metabolic syndrome and diabetes: the population-based Study of Health in Pomerania. Nutrition, Metabolism and Cardiovascular Diseases. 2015 May; 25(5): 458-63. doi: 10.1016/j.numecd.2015.02.002

Kaur J. A comprehensive review on metabolic syndrome. Cardiology Research and Practice. 2014 Oct; 2014: 1-22. doi: 10.1155/2014/943162

Kaya E, Sikka SC, Gur S. A comprehensive review of metabolic syndrome affecting erectile dysfunction. The Journal of Sexual Medicine. 2015 Apr; 12(4): 856-75. doi: 10.1111/jsm.12828

Chen Y, Zhao Q, Du G, Xu Y. Association between serum osteocalcin and glucose/lipid metabolism in Chinese Han and Uygur populations with type 2 diabetes mellitus in Xinjiang: two cross-sectional studies. Lipids in Health and Disease. 2017 Dec; 16(1): 1-0. doi: 10.1186/s12944-017-0512-8

Nyman JS, Even JL, Jo CH, Herbert EG, Murry MR, Cockrell GE, et al. Increasing duration of type 1 diabetes perturbs the strength–structure relationship and increases brittleness of bone. Bone. 2011 Apr; 48(4): 733-40. doi: 10.1016/j.bone.2010.12.016

Hallajzadeh J, Safiri S, Mansournia MA, Khoramdad M, Izadi N, Almasi-Hashiani A, et al. Metabolic syndrome and its components among rheumatoid arthritis patients: a comprehensive updated systematic review and meta-analysis. PLoS one. 2017 Mar; 12(3): e0170361. doi: 10.1371/journal.pone.0170361

Maddaloni E, D’Onofrio L, Lauria A, Maurizi AR, Strollo R, Palermo A, et al. Osteocalcin levels are inversely associated with Hba1c and BMI in adult subjects with long-standing type 1 diabetes. Journal of Endocrinological Investigation. 2014 Jul; 37(7): 661-6. doi: 10.1007/s40618-014-0092-7

Wang Q, Zhang B, Xu Y, Xu H, Zhang N. The relationship between serum osteocalcin concentration and glucose metabolism in patients with type 2 diabetes mellitus. International Journal of Endocrinology. 2013 Oct; 2013: 1-8. doi: 10.1155/2013/842598

Sultan E, Taha I, Saber LM. Altered bone metabolic markers in type 2 diabetes mellitus: Impact of glycemic control. Journal of Taibah University Medical Sciences. 2008 Jan; 3(2): 104-16. doi: 10.1016/S1658-3612(08)70059-3

John WG, Hillson R, Alberti SG. Use of haemoglobin A1c (HbA1c) in the diagnosis of diabetes mellitus. The implementation of World Health Organisation (WHO) guidance 2011. Practical Diabetes. 2012 Jan; 29(1): 12-12a. doi: 10.1002/pdi.1648

Bao YQ, Zhou M, Zhou J, Lu W, Gao YC, Pan XP, et al. Relationship between serum osteocalcin and glycaemic variability in Type 2 diabetes. Clinical and Experimental Pharmacology and Physiology. 2011 Jan; 38(1): 50-4. doi: 10.1111/j.1440-1681.2010. 05463.x

Gundberg CM, Nieman SD, Abrams S, Rosen H. Vitamin K status and bone health: an analysis of methods for determination of undercarboxylated osteocalcin. The Journal of Clinical Endocrinology and Metabolism. 1998 Sep; 83(9): 3258-66. doi: 10.1210/jcem.83.9.5126

Ferron M, Hinoi E, Karsenty G, Ducy P. Osteocalcin differentially regulates β cell and adipocyte gene expression and affects the development of metabolic diseases in wild-type mice. Proceedings of the National Academy of Sciences. 2008 Apr; 105(13): 5266-70. doi: 10.1073/pnas.0711119105

Gu PY, Yu F, Jin S, Yang Q, Su J, Chen Y, et al. Analysis of serum undercarboxylated osteocalcin level in rats with type 2 diabetes mellitus and the correlation with cognitive impairment. Experimental and Therapeutic Medicine. 2017 Sep; 14(3): 2603-7. doi: 10.3892/etm.2017.4838



DOI: 10.54393/pjhs.v3i06.369
Published: 2022-11-30

How to Cite

Mufti, M. ., Khaliq, N. ., Munir, M. ., Khattak, A. ., Mufti, A. ., Ansari, F. ., Hassan, B. ., & Ansar, F. . (2022). Relationship Between Serum Osteocalcin Levels and Glycosylated Hemoglobin in Type II Diabetes Patients: Osteocalcin Levels and Glycosylated Hemoglobin in Diabetes Patients. Pakistan Journal of Health Sciences, 3(06).



Original Article